Hirt S W, Aoki M, Demertzis S, Siclari F, Haverich A, Borst H G
Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Federal Republic of Germany.
J Vasc Surg. 1993 Mar;17(3):538-45. doi: 10.1067/mva.1993.39245.
The purpose of this article is to assess the healing qualities of presealed knitted polyester prostheses.
Thoracic aortic replacement was performed with grafts with four different coating materials-collagen (CP), albumin (AP), and two with gelatin (GP1/GP2)-in four groups of 15 pigs each. Two weeks, 6 weeks, and 6 months after operation, five pigs of each group were killed. Healing quality was assessed by morphometric analysis of the remaining coating, the extent of tissue ingrowth, and the thickness of the inner layer.
The sealant was rapidly absorbed in all prostheses except for the AP (remaining coating at 2 weeks: GP1 22.1%, GP2 34.7%, and CP 68.0% vs AP 97.1% [p < 0.05]), remaining coating at 6 weeks: GP1/GP2 0% and CP 2.5% vs AP 76.7% (p < .01). At 6 months, remaining coating was only detectable in AP (21.5%). At 2 weeks the extent of tissue ingrowth ranged from 65.7% in GP1 and 75.3% in CP to 80% in GP2 versus 8.9% in AP (p < 0.05). There was a slow increase of tissue ingrowth until the sixth postoperative week (GP1 74.4%, GP2 85.0%, and CP 91.3% versus AP 19.6% [p < 0.01]). Thickness of the internal layer varied from 0.11 to 0.21 mm at 2 weeks in all grafts studied and from 1.02 mm (AP) and 1.28 mm (GP2) to 1.39 mm (GP1), versus 0.41 mm in the CP (p < 0.01) after 6 months of implantation.
The type of coating significantly influences the healing properties of knitted polyester prostheses. When used for thoracic aortic replacement in pigs, AP coating clearly results in inferior healing compared with GP1/GP2 or CP impregnation, with digestion of the coating material and tissue ingrowth used as parameters. The thinnest internal layer was found in the CP prostheses, reflecting superior healing properties of this coating in the model studied.
本文旨在评估预密封针织聚酯人工血管的愈合特性。
对四组猪（每组15头）进行胸主动脉置换，使用四种不同涂层材料的人工血管——胶原蛋白（CP）、白蛋白（AP）以及两种明胶（GP1/GP2）。术后2周、6周和6个月，每组处死5头猪。通过对剩余涂层的形态计量分析、组织长入程度和内层厚度来评估愈合质量。
除AP外，所有人工血管中的密封剂均迅速吸收（2周时剩余涂层：GP1为22.1%，GP2为34.7%，CP为68.0%，而AP为97.1%[p<0.05]）；6周时剩余涂层：GP1/GP2为0%，CP为2.5%，而AP为76.7%（p<0.01）。6个月时，仅在AP中可检测到剩余涂层（21.5%）。2周时组织长入程度从GP1的65.7%、CP的75.3%到GP2的80%，而AP为8.9%（p<0.05）。术后第六周前组织长入缓慢增加（GP1为74.4%，GP2为85.0%，CP为91.3%，而AP为19.6%[p<0.01]）。植入6个月后，所有研究的人工血管在2周时内层厚度在0.11至0.21毫米之间，从1.02毫米（AP）和1.28毫米（GP2）到1.39毫米（GP1），而CP为0.41毫米（p<0.01）。
涂层类型显著影响针织聚酯人工血管的愈合特性。在猪胸主动脉置换中，以涂层材料的消化和组织长入为参数，与GP1/GP2或CP浸渍相比，AP涂层明显导致较差的愈合。在CP人工血管中发现最薄的内层，反映了该涂层在本研究模型中的优异愈合特性。
